Dental procedures and endocarditis prophylaxis: experiences from 108 dental practices

Area of Science:

• Cardiology
• Dental Medicine
• Infectious Diseases

Background:

• Patients with prosthetic heart valves require careful management during dental procedures.
• Bacterial endocarditis is a serious risk for individuals with prosthetic heart valves.
• Previous surveys indicated a gap in understanding and practice regarding antibiotic prophylaxis in dentistry for these patients.

Purpose of the Study:

• To assess dentists' awareness and practices regarding antibiotic prophylaxis for patients with prosthetic heart valves.
• To evaluate the adherence of prescribed antibiotic regimens to current guidelines.
• To identify areas for improved patient and dental professional education.

Main Methods:

• A questionnaire survey was distributed to dentists treating patients who underwent cardiac surgery with prosthetic heart valve insertion.
• Data collected included dentists' awareness of prosthetic heart valves, perceived need for antibiotic prophylaxis, and prescribed regimens.
• Prescribed antibiotic dosages, routes, frequencies, and durations were compared against established prophylaxis principles.

Main Results:

• Two-thirds of responding dentists were aware of their patients' prosthetic heart valves.
• The majority believed antibiotic prophylaxis was justified for certain dental procedures.
• Only 14% prescribed prophylactic antibiotics, and over half used regimens not aligned with modern guidelines for preventing bacterial endocarditis.

Conclusions:

• Despite awareness, a significant gap exists in the consistent and correct prescription of antibiotic prophylaxis by dentists for patients with prosthetic heart valves.
• Current practices regarding antibiotic prophylaxis for bacterial endocarditis prevention in dental settings are suboptimal.
• Enhanced education and clear recommendations are crucial for improving dental care and outcomes in this high-risk patient population.